Hi. I'm having a hard time getting a claim paid. I can post all of the Op notes but I have six so I was thinking anyone who wanted to try to tackle this, I can inbox the Op Notes to look at but for now, I will put some side notes in. Blue Cross is the insurance.
12/05/11- Patient had an ultrasound-guided vacuum assisted core biopsy right breast and a marking clip was also used. It was coded 19103-RT and 19295.
12/12/11- office visit- 99214
12/19/11- Right breast lumpectomy & excision of malignant breast tumor with attention to surgical margins; injection of dye for sentinel node biopsy; sentinel node biopsy; complete axillary dissection; intermediate closure. (2 sentinel nodes were dissected, extensive axillary dissection over the boarder of the pectoralis muscle laterally down to the latissimus muscle and carried through to the axillary vein.) It was coded 19302-58-RT, 38252, 38900.
01/09/12- Re-excision lumpectomy for margin revision of the right breast with intermediate closure. (At the deep margin the pectorial fascia had been left in place and this was elevated off the pectoral muscle to create a new deep margin. The lumpectomy cavity was excised en-bloc and marked with a short stitch...) It was coded 19301-58-RT but now I'm not so sure I can code for re-excision? Not sure.
02/13/12- tunneled central line with port and percutaneous seroma drainage. It was coded 36561-58 and 10140-78.
What am I coding incorrect? Any help on this case would be greatly appreciated!!!
12/05/11- Patient had an ultrasound-guided vacuum assisted core biopsy right breast and a marking clip was also used. It was coded 19103-RT and 19295.
12/12/11- office visit- 99214
12/19/11- Right breast lumpectomy & excision of malignant breast tumor with attention to surgical margins; injection of dye for sentinel node biopsy; sentinel node biopsy; complete axillary dissection; intermediate closure. (2 sentinel nodes were dissected, extensive axillary dissection over the boarder of the pectoralis muscle laterally down to the latissimus muscle and carried through to the axillary vein.) It was coded 19302-58-RT, 38252, 38900.
01/09/12- Re-excision lumpectomy for margin revision of the right breast with intermediate closure. (At the deep margin the pectorial fascia had been left in place and this was elevated off the pectoral muscle to create a new deep margin. The lumpectomy cavity was excised en-bloc and marked with a short stitch...) It was coded 19301-58-RT but now I'm not so sure I can code for re-excision? Not sure.
02/13/12- tunneled central line with port and percutaneous seroma drainage. It was coded 36561-58 and 10140-78.
What am I coding incorrect? Any help on this case would be greatly appreciated!!!